Colon capsule versus CT colonography in patients with incomplete colonoscopy: a prospective, comparative trial

Following incomplete colonoscopy (IC) patients often undergo computed tomography colonography (CTC), but colon capsule endoscopy (CCE) may be an alternative. We compared the completion rate, sensitivity and diagnostic yield for polyp detection from CCE and CTC following IC. A systematic literature search resulted in twenty-six studies. Extracted data included inter alia, complete/incomplete investigations and polyp findings. Pooled estimates of completion rates of CCE and CTC and complete colonic view rates (CCE reaching the most proximal point of IC) of CCE were calculated. Per patient diagnostic yields of CCE and CTC were calculated stratified by polyp sizes. CCE completion rate and complete colonic view rate were 76% (CI 95% 68–84%) and 90% (CI 95% 83–95%). CTC completion rate was 98% (CI 95% 96–100%). Diagnostic yields of CTC and CCE were 10% (CI 95% 7–15%) and 37% (CI 95% 30–43%) for any size, 13% (CI 95% 9–18%) and 21% (CI 95% 12–32%) for >5-mm and 4% (CI 95% 2–7%) and 9% (CI 95% 3–17%) for >9-mm polyps. No study performed a reference standard follow-up after CCE/CTC in individuals without findings, rendering sensitivity calculations unfeasible. The increased diagnostic yield of CCE could outweigh its slightly lower complete colonic view rate compared to the superior CTC completion rate. Hence, CCE following IC appears feasible for an introduction to clinical practice. Therefore, randomized studies investigating CCE and/or CTC following incomplete colonoscopy with a golden standard reference for the entire population enabling estimates for sensitivity and specificity are needed.

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Mo1669 DETECTION OF ≥10MM POLYPS BY COLON CAPSULE ENDOSCOPY VERSUS CT COLONOGRAPHY: A POST-HOC ANALYSIS

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2018.04.2027 ◽

2018 ◽

Vol 87 (6) ◽

pp. AB471

Author(s):

Shinichi Katsuki ◽

Kenichi Utano ◽

Tomoki Matsuda ◽

Tomoki Fujita ◽

Katsuhiko Mitsuzaki ◽

...

Keyword(s):

Capsule Endoscopy ◽

Ct Colonography ◽

Post Hoc Analysis ◽

Colon Capsule Endoscopy ◽

Colon Capsule ◽

Post Hoc

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PWE-355 Ct-colonography use in incomplete colonoscopy and frail patients

Gut ◽

10.1136/gutjnl-2015-309861.801 ◽

2015 ◽

Vol 64 (Suppl 1) ◽

pp. A366.2-A366

Author(s):

U Pisano ◽

D Eason ◽

E Semple ◽

A Banerjee ◽

J Docherty ◽

...

Keyword(s):

Ct Colonography ◽

Incomplete Colonoscopy ◽

Frail Patients

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Colon capsule endoscopy is feasible to perform after incomplete colonoscopy and guides further workup in clinical practice

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2013.07.061 ◽

2014 ◽

Vol 79 (2) ◽

pp. 307-316 ◽

Cited By ~ 45

Author(s):

Konstantinos Triantafyllou ◽

Nikos Viazis ◽

Panagiotis Tsibouris ◽

Georgios Zacharakis ◽

Chryssostomos Kalantzis ◽

...

Keyword(s):

Clinical Practice ◽

Capsule Endoscopy ◽

Incomplete Colonoscopy ◽

Colon Capsule Endoscopy ◽

Colon Capsule

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Tu1556 Cost Effectiveness Analysis of Enteroscope Utilization Versus Colon Capsule or Computed Tomography Colonoscopy for Patients With Incomplete Colonoscopy

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2014.02.1002 ◽

2014 ◽

Vol 79 (5) ◽

pp. AB584

Author(s):

Lauren B. Gerson ◽

Christian S. Jackson

Keyword(s):

Computed Tomography ◽

Cost Effectiveness ◽

Cost Effectiveness Analysis ◽

Incomplete Colonoscopy ◽

Effectiveness Analysis ◽

Colon Capsule

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Comparison of a 4-Day versus 2-Day Low Fiber Diet Regimen in Barium Tagging CT Colonography in Incomplete Colonoscopy Patients

Gastroenterology Research and Practice ◽

10.1155/2015/609150 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Kaan Meric ◽

Nuray Bakal ◽

Ebubekir Şenateş ◽

Sibel Aydın ◽

Zeynep Gamze Kılıçoğlu ◽

...

Keyword(s):

Patient Compliance ◽

Bowel Preparation ◽

Ct Colonography ◽

Barium Sulphate ◽

Diet Group ◽

Incomplete Colonoscopy ◽

Fiber Diet ◽

Significant Difference ◽

Diet Regimen ◽

Bowel Segments

Our aim was to compare the amount of residual feces, residual fluid, the tagging quality, and patient compliance using 4-day versus 2-day low fiber diet regimen in barium tagging CT colonography in incomplete colonoscopy patients.Methods.A total of 101 patients who underwent CT colonography were assigned to 2-day diet group (n=56) and 4-day diet group (n=45). Fecal tagging was achieved with barium sulphate while bisacodyl and sennoside B were used for bowel preparation. Residual solid stool was divided into two groups measuring <6 mm and ≥6 mm. We graded the residual fluid, tagging quality for solid stool, and fluid per bowel segment. We performed a questionnaire to assess patient compliance.Results.604 bowel segments were evaluated. There was no significant difference between 2-day and 4-day diet groups with respect to residual solid stool, residual fluid, tagging quality for stool, and fluid observed in fecal tag CT colonography (P>0.05). The prevalence of moderate discomfort was significantly higher in 4-day group (P<0.001).Conclusion.Our study shows that 2-day limited bowel preparation regimen for fecal tag CT colonography is a safe and reasonable technique to evaluate the entire colon, particularly in incomplete conventional colonoscopy patients.

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Collaboration between an NHS University Teaching Hospital and independent hospital to maintain CT colonography service provision during the 2020 COVID-19 pandemic

BJR|Open ◽

10.1259/bjro.20210025 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Paul Holland ◽

Deborah De Abreu ◽

Yutaro Higashi ◽

Christopher GD Clarke

Keyword(s):

Teaching Hospital ◽

Service Provision ◽

Ct Colonography ◽

Blood Count ◽

University Teaching ◽

Full Blood Count ◽

Surgical Team ◽

Image Transfer ◽

Incomplete Colonoscopy ◽

Hospital Site

Our trust performed CTCs at 93% of the capacity of the previous year, scanning 1265 patients in 2020, compared with 1348 in 2019. We describe the changes made to our service to achieve this, which included collaboration with the colorectal surgical team to prioritise existing CTC patients according to faecal-immunochemical tests and full blood count results, and the associated challenges which included image transfer delays and patient attendance for scans. Furthermore, the endoscopy and radiology services used the opportunity created by co-location at the same hospital site to provide a same day incomplete colonoscopy and staging service for optically confirmed cancers. Collaboration between the NHS and independent sector allowed us to achieve continuity of service provision during the height of the COVID-19 pandemic without substituting unprepared CT abdomen and pelvis instead of the more sensitive CTC.

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